Top 5 Takeaways

1. First Local Transmission: This report documents the first locally transmitted cases of Seoul hantavirus (SEOV) infection in the District of Columbia.
2. Severe Symptoms: Both patients exhibited severe symptoms including high fever, thrombocytopenia, and acute kidney injury.
3. Occupational Exposure: Patient A had frequent rodent sightings at his workplace, while Patient B had no known rodent exposure, highlighting different risk scenarios.
4. Diagnostic Confirmation: Serology confirmed SEOV infection in both patients with high IgG and IgM titers.
5. Public Health Implications: The cases underscore the importance of considering hantavirus in differential diagnoses and reporting notifiable diseases to health departments.

Original Article Author and Citation

Corresponding Author

Nivedita Ravi-Caldwell, nivedita.ravi-caldwell@dc.gov

Suggested Citation

Ravi-Caldwell N, Iyengar P, Davies-Cole J. Notes from the Field: First Reports of Locally Transmitted Seoul Hantavirus Infection — District of Columbia, May 2018–December 2018. MMWR Morb Mortal Wkly Rep 2022;71:359–360. DOI: http://dx.doi.org/10.15585/mmwr.mm7109a3

Summary

In May 2018, a 30-year-old man (Patient A) in DC presented with severe symptoms including high fever, thrombocytopenia, and acute kidney injury. He was later diagnosed with Seoul hantavirus (SEOV) infection. Five months later, a 37-year-old man (Patient B) with a history of chronic kidney disease exhibited similar severe symptoms and was also diagnosed with SEOV. Both patients responded to supportive treatment and were discharged. These cases represent the first locally transmitted SEOV infections in DC, highlighting the need for awareness and reporting of hantavirus infections.

Methods

Both patients underwent comprehensive testing for infectious etiologies, which included serology for hantavirus immunoglobulin (Ig) M and IgG. The serology results showed high titers (>1:6,400) confirming recent SEOV infection. Additional tests to rule out other infectious causes returned negative results.

Discussion

These cases highlight the potential for SEOV transmission in urban settings with high rodent populations. Patient A’s occupational exposure to rodents and Patient B’s lack of known exposure suggest varied risk factors. The findings emphasize the importance of including hantavirus in differential diagnoses for patients with compatible symptoms and history of rodent exposure or travel. Enhanced public health measures and reporting are crucial for managing and investigating such infections.

Conclusion

The documented cases of SEOV in DC underscore the need for vigilance in diagnosing and reporting hantavirus infections. Public health efforts should focus on rodent control and educating the public on hygiene practices to minimize infection risks. Physicians should consider hantavirus in patients with relevant symptoms and exposure history.

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